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  • 1
    In: Modern Pathology, Elsevier BV, Vol. 36, No. 6 ( 2023-06), p. 100124-
    Type of Medium: Online Resource
    ISSN: 0893-3952
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
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  • 2
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 83, No. 5_Supplement ( 2023-03-01), p. P4-09-08-P4-09-08
    Abstract: Background: Morphological features of cancer cell nuclei are routinely used to assess disease severity and prognosis, and cancer nuclear morphology has been linked to genomic alterations. Quantitative analyses of the nuclear features of cancer cells and other tumor-resident cell types, such as cancer-associated fibroblasts (CAFs), may reveal novel biomarkers for prognosis and treatment response. Here, we applied a pan-cancer nucleus detection and segmentation algorithm and a cell classification model to hematoxylin and eosin (H & E)-stained whole slide images (WSIs) of breast cancer specimens, enabling the measurement of morphological features of nuclei of multiple cell types within a tumor. Methods: Convolutional Neural Network models for 1) nucleus detection and segmentation and 2) cell classification were deployed on H & E-stained WSIs from The Cancer Genome Atlas (TCGA) breast cancer dataset (primary surgical resections; N=890). Separate models were trained to segment regions of stromal subtypes, such as inflamed and fibroblastic stroma. Nuclear features (area, axis length, eccentricity, color, and texture) were computed and aggregated across each slide to summarize slide-level nuclear morphology for each cell type. Next-generation sequencing-based metrics of genomic instability (N=774) and gene expression (N=868) were acquired and paired with TCGA WSIs. Gene set enrichment analysis was performed using the Molecular Signatures Database. Spearman correlation compared nuclear features to genomic instability metrics. Linear regression was used to assess the relationship between nuclear features and bulk gene expression. Multivariable Cox regression with age and ordinal tumor stage as covariates was used to find association between overall survival (OS) and nuclear features. All reported results were significant (p & lt; 0.05) when adjusted for false discovery rate via the Benjamini-Hochberg procedure. Results: Variation in cancer cell nuclear area, a quantitative metric related to pathologist-assessed nuclear pleomorphism, was calculated by the standard deviation of the nuclear area of cancer cells across a WSI. This feature was associated with genomic instability, as measured by aneuploidy score (r=0.448) and homologous recombination deficiency score (r=0.382), and reduced OS. In contrast, the variability in fibroblast and lymphocyte nuclear areas did not correlate with either metric of genomic instability (all r & lt; 0.1, p & gt;0.05). Furthermore, an association between variation in cancer cell nuclear area with the expression of cell cycle and proliferation pathway genes was observed, suggesting that increased nuclear size heterogeneity may indicate a more aggressive cancer phenotype. Features quantifying CAF nuclear morphology were also assessed, revealing that CAF nucleus shape (larger minor axis length) was associated with lower OS, as well as the expression of gene sets involved in extracellular matrix remodeling and degradation. Conclusions: The nuclear morphologies of breast cancer cells and CAFs reflect underlying genomic and transcriptomic properties of the tumor and correlates with patient outcome. The application of digital pathology analysis of breast cancer histopathology slides enables the integrative study of genomics, transcriptomics, tumor morphology, and overall survival to support research into disease biology research and biomarker discovery. Citation Format: John Abel, Christian Kirkup, Filip Kos, Ylaine Gerardin, Sandhya Srinivasan, Jacqueline Brosnan-Cashman, Ken Leidal, Sanjana Vasudevan, Deepta Rajan, Suyog Jain, Aaditya Prakash, Harshith Padigela, Jake Conway, Neel Patel, Benjamin Trotter, Limin Yu, Amaro Taylor-Weiner, Emma L. Krause, Matthew Bronnimann, Laura Chambre, Ben Glass, Chintan Parmar, Stephanie Hennek, Archit Khosla, Murray Resnick, Andrew H. Beck, Michael Montalto, Fedaa Najdawi, Michael G. Drage, Ilan Wapinski. AI-based quantitation of cancer cell and fibroblast nuclear morphology reflects transcriptomic heterogeneity and predicts survival in breast cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-09-08.
    Type of Medium: Online Resource
    ISSN: 1538-7445
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2023
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  • 3
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 83, No. 5_Supplement ( 2023-03-01), p. P6-04-08-P6-04-08
    Abstract: Background: Neoadjuvant treatment of breast cancer has been shown to potentially reduce the extent and morbidity of subsequent surgery. Response to neoadjuvant therapy may also be prognostic; complete pathologic response (pCR) following neoadjuvant treatment is associated with improved long-term outcomes. pCR, defined as the absence of residual invasive cancer, is determined by evaluation of H & E-stained breast resections and regional lymph nodes following neoadjuvant treatment; however, pathologist assessment is subject to intra- and inter-reader variability. Here we report machine learning (ML)-based models to identify tissue regions and cell types in the tumor microenvironment (TME) of H & E-stained breast cancer specimens. Model predictions were used to derive tumor bed area, a key component of the residual cancer burden score (RCB) used to assess neoadjuvant-treatment pathological response. Methods: Convolutional neural network (CNN) models were trained using digitized H & E-stained whole slide images (WSIs) of 2700 neoadjuvant-treated breast cancer specimens (resections and biopsies) from 4 sources, and an additional 1100 breast cancer primary resections from TCGA. 229,901 pathologist annotations were used to train CNN models to segment tissue regions (cancer epithelium, stroma, diffuse inflammatory infiltrate, ductal carcinoma in situ, lymph nodes and necrosis) and cell types (cancer epithelial cells, fibroblasts, lymphocytes, macrophages, foamy macrophages and plasma cells) at single-pixel resolution. These tissue region segmentations were then used to derive tumor bed area using a convex hull algorithm. Each model was evaluated by board certified pathologists for performance. Model predictions of tumor bed area were evaluated in comparison to mean measurements from 3 pathologists for each of 22 held-out test slides. To further assess cell model performance, 5 pathologists exhaustively annotated 120 frames (300 x 300 pixels) on test samples from a dataset not used in model development (N=536; resections and biopsies) to produce consensus ground truth cell labels. Model predictions were compared with pathologist annotations in these frames using Pearson correlation, precision, recall, and F1 metrics. Only those classes with greater than 50 consensus cells identified were evaluated. Results: CNN predictions of tissue and cell classes within H & E breast cancer WSIs showed concordance with manual pathologist consensus labels. The weighted average Pearson correlation (across the relevant cell types) between the model and consensus was 0.75, comparable to the correlation of 0.81 between pathologists and consensus. Classification metrics for each cell class are reported in Table 1. Reduced performance of the model relative to the average pathologist performance may be due to heterogeneous slide characteristics and infrequency of some cell types in the data. For prediction of tumor bed area, CNN model predictions showed moderate correlation with pathologist consensus (Pearson r=0.65, 95% CI: 0.38-0.81). Conclusions: CNN model classification of cell types and tissue regions across entire H & E breast cancer WSIs shows concordance with pathologist consensus. Model predictions of tumor bed area also show concordance with pathologist assessment and can be used to derive the RCB score. These models can be reproducibly applied to quantify diverse histological features in large datasets, potentially enabling improved standardization and efficiency of pathologist evaluation of the breast cancer TME and neoadjuvant response. Classification Metrics for Individual Cell Classes Citation Format: Christian Kirkup, Sanjana Vasudevan, Filip Kos, Benjamin Trotter, Murray Resnick, Andrew H. Beck, Michael Montalto, Ilan Wapinski, Ben Glass, Mary Lin, Stephanie Hennek, Archit Khosla, Michael G. Drage, Laura Chambre. Machine learning-based characterization of the breast cancer tumor microenvironment for assessment of neoadjuvant-treatment response [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Phila delphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-04-08.
    Type of Medium: Online Resource
    ISSN: 1538-7445
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2023
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    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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